Hayakawa Yuka, Kobayashi Katsumasa, Sakamoto Naoya, Matsuoka Mana, Nozaka Takahito, Misumi Yoshitsugu, Matsumoto Taichi, Miura Natsuki, Furumoto Yohei, Asano Toru, Horiuchi Takao, Fujiki Kazuhiko
Department of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital, 4-23-15, Kotobashi, Sumida, Tokyo, 130-8575, Japan.
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh Hospital, Sumida, Tokyo, Japan.
Clin J Gastroenterol. 2020 Feb;13(1):17-21. doi: 10.1007/s12328-019-01028-z. Epub 2019 Jul 27.
While antiretroviral therapy has improved mortality in patients with human immunodeficiency virus (HIV) infections, deaths caused by non-acquired immunodeficiency syndrome-defining malignancies are increasing. A woman in her 70s with HIV infection who was receiving antiretroviral therapy presented with dysphagia. She was diagnosed with esophageal cancer (cT3N2M0, stage III). She received neoadjuvant chemotherapy (cisplatin and 5-fluorouracil) and radiotherapy. During treatment, we continued administering antiretroviral therapy and prophylaxis for opportunistic infections, with due attention to side effects and drug-drug interactions. No severe adverse events occurred. The primary lesion and metastatic lymph nodes decreased in size after treatment; however, 1 month later, her cancer spread to other organs; thus, surgery was canceled. Her general condition rapidly worsened. She eventually died of cancer cachexia and aspiration pneumonia. No previous reports have mentioned the treatment plan and management of esophageal cancer in HIV-positive patients. This report presents a case of esophageal cancer with HIV infection that progressed rapidly after neoadjuvant chemoradiotherapy.
虽然抗逆转录病毒疗法已降低了人类免疫缺陷病毒(HIV)感染者的死亡率,但由非获得性免疫缺陷综合征定义的恶性肿瘤导致的死亡人数却在增加。一名70多岁接受抗逆转录病毒治疗的HIV感染女性出现吞咽困难。她被诊断为食管癌(cT3N2M0,III期)。她接受了新辅助化疗(顺铂和5-氟尿嘧啶)及放疗。在治疗期间,我们继续给予抗逆转录病毒治疗并预防机会性感染,同时密切关注副作用和药物相互作用。未发生严重不良事件。治疗后原发灶和转移淋巴结体积缩小;然而,1个月后,她的癌症扩散至其他器官,因此取消了手术。她的总体状况迅速恶化。她最终死于癌症恶病质和吸入性肺炎。此前尚无报告提及HIV阳性患者食管癌的治疗方案和管理。本报告介绍了1例HIV感染合并食管癌患者在新辅助放化疗后病情迅速进展的病例。